Related Experiment Videos
[Myringoplasty in children: a comparison with an adult population]
R Albera1, F Milan, E Riontino
1Dipartimento di Fisiopatologia Clinica, II, Università di Torino.
Insights
Myringoplasty is a safe and effective surgical procedure for children with simple tympanic membrane perforations. This study found similar success rates and functional outcomes compared to adults, suggesting no need to delay surgery until skeletal maturity.
Area of Science:
- Otolaryngology
- Pediatric Surgery
Background:
- Myringoplasty in children is controversial due to concerns about high rates of ear infections impacting success.
- Previous studies have questioned the efficacy of myringoplasty in pediatric patients.
Purpose of the Study:
- To evaluate the safety and efficacy of myringoplasty in children under 17 years old with simple tympanic membrane perforations.
- To compare surgical outcomes and functional results in children versus adult patients.
Main Methods:
- A cohort of 23 pediatric patients underwent myringoplasty using underlay or overlay techniques based on perforation location.
- Surgical approaches included transmeatal and retroauricular methods.
- Outcomes were compared to 150 adult patients undergoing the same procedure.
Main Results:
- A low rate of new perforations (9%) was observed in the pediatric group.
- Significant improvement in the air/bone conduction gap (average 10 dB) was achieved.
- Success rates and functional outcomes in children were comparable to those in the adult control group (15% new perforations).
Conclusions:
- Myringoplasty is a safe and effective procedure for children with simple tympanic membrane perforations.
- The study suggests that myringoplasty can be performed in children without necessitating a delay until skeletal maturity.
Abstract:
The indications for myringoplasty in children has always been a controversial subject since many authors feel the high frequency of the phlogistic auricular processes in children constitute an unfavorable prognostic factor to success of the procedure. The authors present the results obtained in 23 patients under 17 years of age who had undergone myringoplasty for simple perforation of the tympanum. In cases of posterior and inferior perforations, surgery was performed using the underlay technique and a transmeatal approach; in all other cases the overlay technique was used with a retroauricular approach. An average 30 month follow-up (range 12-55 months) revealed new perforations in only 2 cases (9%). From the functional point of view the average air/bone conduction gap was reduced to 10 dB. As a control, the results were compared to those obtained in 150 patients over 16 years of age, again affected by simple perforation of the tympanic membrane and treated by myringoplasty using the same methods. In the adults, 22 new perforations were found (15%) while the functional results were analogous to those obtained in the children group. In this light, it can be asserted that myringoplasty can be considered a safe procedure to be used in children and it does not appear essential to wait until they have finished growing before performing this procedure.